Journal article
Adjuvant External Radiation Impacts Outcome of Pelvis-limited Stage III Endometrial Carcinoma: A Multi-institutional Study
American journal of clinical oncology, Vol.41(8), pp.792-796
08/2018
DOI: 10.1097/COC.0000000000000371
PMID: 28225446
Abstract
Adjuvant therapy choice for women with FIGO stage III endometrial carcinoma (EC) is controversial. We investigate the comparative benefit of adjuvant chemotherapy (CT) alone, radiation therapy alone (RT) or in combination (chemotherapy and radiation therapy [CRT]) with respect to recurrence-free survival (RFS) and overall survival (OS) in women with pelvis-limited (PL) EC (stage IIIA, IIIB, and IIIC1). A multi-institutional database of 270 surgically staged women with PLEC was analyzed. Univariate log-rank analyses and Cox regression multivariate analyses (MVA) were performed to identify factors associated with RFS and OS. Median RFS and OS were 112 and 130 months, respectively, for the full cohort. Adjuvant treatment was CT in 21%, RT in 27%, and CRT in 47%. Age, year of treatment, grade, histology, and adjuvant treatment were significantly associated with RFS and OS on univariate analysis. PLEC patients receiving CT alone fared worse in terms of RFS (P=0.07 relative to RT and <0.01 relative to CRT). On MVA, CRT retained significantly improved RFS relative to CT (hazard ratio for recurrence 0.38, P<0.01). PLEC patients receiving RT or CRT had improved OS compared with CT, P<0.01 and 0.03, respectively. On MVA, both RT only and CRT retained association with improved OS relative to CT alone (hazard ratio for death, 0.43, P=0.02 and 0.40, P<0.01, respectively). For surgically staged PL stage III EC, treatment regimens incorporating RT were associated with improved survival endpoints relative to CT alone. As such, RT should be considered an important component in the adjuvant management of stage III PLEC.
Details
- Title: Subtitle
- Adjuvant External Radiation Impacts Outcome of Pelvis-limited Stage III Endometrial Carcinoma: A Multi-institutional Study
- Creators
- Kevin Albuquerque - Department of Radiation OncologyMichael Folkert - Department of Radiation OncologyJyoti Mayadev - Department of Radiation Oncology, Davis Comprehensive Cancer Center, University of California, Sacramento, CAAlana Christie - Divisions of Gynecologic OncologyMargaret R Liotta - Departments of Gynecologic OncologyChrista Nagel - Department Gynecological Oncology, UH Case Medical Center, Cleveland, OHParag Sevak - Henry Ford Hospital, Division of Radiation Oncology, Detroit, MIMatthew M Harkenrider - Departments of Gynecologic OncologyJayanthi S Lea - Divisions of Gynecologic OncologyRabbie K Hanna - Henry Ford Hospital, Division of Radiation Oncology, Detroit, MIWilliam C Small Jr - Radiation Oncology, Loyola University Chicago, Maywood, ILDavid S Miller - Divisions of Gynecologic OncologyXian-Jin Xie - Biostatistics, UT Southwestern Medical Center, Dallas, TXRonald K Potkul - Departments of Gynecologic OncologyMohamed A Elshaikh - Henry Ford Hospital, Division of Radiation Oncology, Detroit, MI
- Resource Type
- Journal article
- Publication Details
- American journal of clinical oncology, Vol.41(8), pp.792-796
- Publisher
- United States
- DOI
- 10.1097/COC.0000000000000371
- PMID
- 28225446
- ISSN
- 0277-3732
- eISSN
- 1537-453X
- Language
- English
- Date published
- 08/2018
- Academic Unit
- Preventive and Community Dentistry; Biostatistics; Dental Research
- Record Identifier
- 9983917790202771
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